Monday, April 30, 2012

Some fine work at the Rapid City Regional Hospital: Vern Traversie's torso.

One of the latest episodes in South Dakota's relentless war against the Native Americans occurred in the Rapid City Regional Hospital surgery and intensive care rooms, according to reports in online American Indian media.

The battle objective and casualty was Vernon Traversie of Eagle Butte on the Cheyenne River Reservation. Vern is 69, diabetic, and blind.

Vern ended up having double by-pass surgery. According to his story as reported by the online source Last Real Indians, the surgery was delayed a number of times for unspecified reasons. Vernon is reported saying, “I was supposed to have emergency surgery on my heart, but they
(hospital) had scheduling problems. Every night they would prep me for
surgery which went on for four or five days. Every night they would
shave my chest and stomach and wouldn’t feed me.”

However, the real story begins when Vernon prepared to leave the hospital. He says a hospital worker "came into his room and advised him to have pictures taken of his chest
and abdomen as soon as he got home. He says she told him that she could
not testify for him, but that her conscience got the better of her and
she didn’t agree with what they did to him."

The day after he came home, a home care nurse looked at his torso and saw signs of mutilation, including three K's carved or burned into his skin. She took pictures and took them to a tribal health facility which called in the tribal police who informed the FBI.

Traversie consulted with a lawyer, who did some cursory checking on the incident but took no action. The police have not taken any action, either. Tribal officers are attempting to get some investigation on the case. The hospital has not supplied any information. The Rapid City Journal elicited the usual bureaucratic evasion on the grounds that no one has permission to to anything:

When asked for comment about Traversie’s claims, a Rapid City Regional Hospital spokeswoman released a statement from Tim Sughrue, chief executive officer of the hospital.

“Rapid City Regional Hospital is committed to providing all patients, regardless of race or culture, with compassionate and exceptional care,” Sughrue said in the written statement. “We are unable to comment on a patient’s treatment without consent. In the absence of permission, it is not possible to respond to specific questions.”

The question is just who has to give permission for the hospital to comment on the case. Vern Traversie has made requests for information, which means he has given permission to release information on his treatment.

The Indian online media, including the Indian Country Today Media Network, have treated the incident as a hate crime, which it may be. But as significant is the malfunctioning of the hospital and the investigative agencies that have authority over the delivery of healthcare and justice.

The hospital's stance is a glaring violation of the standards performance and ethics that define the healthcare professions, as specified in the typical Declaration for New Doctors which 98 percent of American doctors take in some form. It includes these pledges:

I will practise medicine with integrity, humility, honesty, and compassion—working with my fellow doctors and other colleagues to meet the needs of my patients.

I shall never intentionally do or administer anything to the overall harm of my patients.

I will not permit considerations of gender, race, religion, political affiliation, sexual orientation, nationality, or social standing to influence my duty of care.

I will oppose policies in breach of human rights and will not participate in them. I will strive to change laws that are contrary to my profession's ethics and will work towards a fairer distribution of health resources.

According to Vern Traversie, those basic conditions of medical treatment were denied him. There are hospitals that pay little heed to their medical and soial responsibilities and seem not to offer much in the way of education and supervision to insure that the care being delivered is competent and responsible.

I can attest that the personnel in a hospital can perform more like characters in horror movies from an experience I had in Ft. Morgan, Colorado. While traveling to Denver, we were rear-ended on Interstate-76 that passes through Ft. Morgan. I now realize that I, who was driving, was stunned and disoriented because I did not realize what happened and had difficulty bringing the car to a stop. We got out of our car and were strapped by emergency personnel to immobilization boards, which began some of the worst hours I have endured. You can read the details at the above link, but I will forever remember the emergency room physician and nurse. I nominate them for the World Class Colorectal Prize for their stupendous achievement as assholes. However, the only person we encountered during that experience in Ft. Morgan who performed with efficiency and integrity was the deputy sheriff who took charge of our greyhound while we were undergoing mistreatment. So, I know how bad hospitals can be.

One would assume that if a hospital received a complaint about mistreatment, its first concern would be to investigate the matter and resolve any issues it found. Rapid City Regional instead invokes the bureaucratic oath to do nothing that might cause embarrassment and discomfort to the administrative staff. For anyone who has a choice about where to seek some medical treatment, this performance on the Traversie incident should be a big factor. The hospital recently expanded its emergency treatment facility, which suggests that it is going after more involuntary patients.

There are basic procedures and requirements in the medical treatment of patients involved that, if followed, would made the resolution of Vern Traversie's complaint routine. It involves all the personnel who treated him. The symptoms of mutilation that show in the picture should be annotated on his medical chart. And the doctors who are in charge of his treatment should have recorded their observations, explanations, and recommended treatment.

However, RCRH is by no means the only agency in this story that fails to live up to any professional standards of conduct and performance in discharging its function. The fecklessness of the lawyer is, however, what is expected among the legal profession. The health service and law enforcement agencies have also have responsibilities and the means to discharge them.

The claims made by Vern Traversie and those who have witnessed his injuries are law enforcement matters. There is evidence that laws have been broken. That means that there is probable cause that a crime has been committed. As one who has reported on court proceedings in such matters, I can outline the resources available to law enforcement and legal personnel in investigating them. Law enforcement agencies can use the probable cause to have a search warrant issued for all the medical records in the Vern Traversie incident. Law enforcement agents can also question the hospital and medical personnel, and if Mr. Traversie has given full permission to conduct an investigation that involves his personal records, the hospital and medical personnel cannot hide behind that contention that they are restrained from releasing information.

If a lawyer pursues the incident as a civil matter, he/she may obtain information and testimony through court order. However, because a felony may be involved, the courts can require expeditious disclosures of information.

The primary issue involved is Vern Traversie's rights. Not the hospital's or the investigative agencies'.

If Vern Traversie has no rights to observe in this matter, none of us have any rights in obtaining competent and dutiful treatment, whether a matter of medicine or justice.

5 comments:

No specific information about who was treating Vern Traversie has been released. However, a quick check shows that Picardi is a general surgery and not affiliated with the Heart Doctors, whom I assume had charge of his case.

What is hard to figure is why whichever physician was in charge, and would have examined Vern regularly and authorized his final dismissal would not have noted the extraneous wounds around the incision. This is a very messy business.

You write "For anyone who has a choice about where to seek some medical treatment, this performance on the Traversie incident should be a big factor." There is no choice for Natives, Indian Health Services will not provide quality care for First Nations people, so they wander to the for-profit clinics.

First glance shows a terrible (at best) stitch and dressing. This care would not be acceptable on the family pet.

I am no apologist for hospitals, but I wonder if what appears to be a "K" is actually an opening for a minimally-invasive surgery tool or tube. Would it have been different if it were an "X" instead of a "K"? You may also note that the patient has a fat gut. That may complicate "neat" surgery and sewing.

Perhaps I am naive in this, but I seriously doubt any South Dakota hospital professionals would intentionally do needless damage to any patient of any color or nationality.